Wednesday, October 26, 2016

Battling Brain Disease: The New Frontier In Treating Alzheimer's Patients

Sometimes when John Chiappetta’s mother makes her much-loved lasagna,
she remembers every detail of every step. Other times, if Chiappetta
isn’t there to prevent her, she boils the water down to the pot’s metal.
Such is the unpredictable nature of the Alzheimer’s disease that she’s
battling.

For five years, Chiappetta has been his mother’s full-time
caregiver, while working full-time as a senior program manager at Hyatt
Hotels and fulfilling his duties as a single father to three boys.

Taking care of his mom is an endurance-testing responsibility. It
requires ingenuity, determination and fortitude.

“I’ve had to do a lot of adjusting, and you need a whole lot of
patience,” said Chiappetta, who lives in Chicago. “You become a driver
[for her], medical advocate and translator. You actually need to become her memory.”

More than 5 million Americans are living with Alzheimer’s disease,
and the number is expected to triple in another 35 years. By far the
most common brain disorder, Alzheimer’s has long eluded researchers’
attempts at finding its cause. Efforts to develop long-term treatment
protocols have fared no better. Most pharma organizations are attacking
the disease in either of two ways: pursuing possible triggers or seeking
treatments to help subdue symptoms.

Integrating Approaches

But Lundbeck,
a global pharmaceutical company with North American headquarters in
Deerfield, Illinois, is taking a two-pronged approach — testing
medications to minimize symptoms and examining the causes. Its efforts
to combat Alzheimer’s are part of the company’s larger mission to
target malfunctions of the central nervous system and the underlying
mechanisms of brain disorders.

In addition to Alzheimer’s, Lundbeck’s
research and development investigates and offers treatments for
Parkinson’s disease, schizophrenia, depression and epilepsy.

“Ultimately we’d like to eliminate Alzheimer’s, but
until then we’re hoping to change the course of the illness and slow it
down,” said Peter Anastasiou, president of Lundbeck North America.

Lundbeck currently has five drugs in clinical trials for
Alzheimer’s. Three of them are considered disease-modifying, which
potentially could alter the progression of the illness. Two others
address the symptoms: one lessens the impact of cognitive deficits; the other calms the agitation that typically occurs in people with Alzheimer’s.

Of the five compounds, the three potentially disease-altering
medications are in the very early stages of clinical trials and are not
yet named. They are still being studied for safety before they can be
tested for their effectiveness.

One is a vaccine that would teach the body to rid the brain of beta
amolyid, the chunks of protein that clump together and are believed to
block cell-to-cell signals, leading to the cognitive deficits associated
with Alzheimer’s. Many researchers believe beta amolyid holds the key
to curing the disease.

The second is a drug that Lundbeck hopes will stop the production of
beta amolyid altogether. The third is aimed at reducing the accumulation
of tau tangles, characterized by protein clusters that are believed to
interfere with the cell transport system. This interference prevents
nutrients and other necessary supplies from traveling through and
nourishing cells, eventually causing the cells to die.

“It’s so important to find out what causes this disease,” Chiappetta said.

Buying Time

Until a cure can be found, two Lundbeck medications might improve the
quality of life for patients struggling with Alzheimer’s deficiencies.
Idalopirdine boosts the activity of neurotransmitters, potentially
improving cognitive function. Early studies have shown some positive
effects. Phase III clinical trials are underway.

The other compound, Rexulti (brexpiprazole)‎, is already on the market, but
for a different indication. It is FDA-approved to help patients with
schizophrenia and depression. Lundbeck is investigating whether the drug
effectively reduces agitation in Alzheimer’s patients, a prominent
behavior associated with the disease and a leading cause of nursing home
care.

Watching someone battle with Alzheimer’s can be heart-wrenching,
according to Chiappetta. There are times when he sees his mother fight
with herself to find the right words. “Certain days are good and certain
days are horrible,” he said. “You just see her language eroding and the
frustration. You just have to keep her engaged as much as possible.”

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